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University of Michigan concierge medical care program draws protests

Detroit Free Press (MI)

March 09--MICHIGAN MEDICINETHE HEALTH SYSTEM OWNED BY THE UNIVERSITY OF MICHIGAN -- IS DRAWING FIRE FROM ITS OWN STAFF OVER A PLAN TO OFFER PERSONALIZED SERVICE, Reduced waiting times and preferential access to physicians for a hefty yearly fee. -- the health system owned by the University of Michigan -- is drawing fire from its own staff over a plan to offer personalized service, reduced waiting times and preferential access to physicians for a hefty yearly fee.

The plan, part of the growing nationwide movement known as concierge care, is drawing protests from U-M doctors who are concerned it strays from the institution's public mission. The program is currently enrolling patients.

"Victors Care purports to offer 'better' health care to those with enough money to pay a large access fee," says a letter sent to the health system's administration by 200 doctors and staff. "The University of Michigan is a public institution and our commitment is to serve the public, not a private few. We do not feel this is the role of a state university and are unable to justify this to the patients and families we serve."

The program works like this, according to the Victors Care website: People interested in the program pay a yearly fee -- $2,700 now, going up to $3,600 after July 1. In exchange, the program promises shorter waits in waiting rooms, more face time with doctors, 24-hour access to a doctor via e-mail and the doctor's cell phone number, and "assistance" with scheduling tests and other specialty appointments.

"We urge Michigan Medicine leadership to focus on increasing access for all of our patients," the letter from the Michigan Medicine staff says. "We need greater efforts to improve infrastructure, space, and clinic support for all. We are eager to promote and strengthen primary care services at the University of Michigan, but we feel strongly this should be done for all patients, not based on their ability to pay."

The Free Press asked Michigan Medicine for interviews with any member of the administration, but were told none was available. It instead issued a statement to the Free Press:

"We're committed to ethical, accessible care for all our patients and whatever programs we put in place should not diminish that in any way. This will not adversely affect the access of other patients to our outstanding health care system.

"Some faculty have raised concerns. We've listened to them and are working together to come up with solutions that are mutually satisfactory for the benefit of our patients.

"Along with accepting many different types of insurance that provide different types of support for patient care, we think Victors Care is a valuable option to offer our patients."

In addition to the letter, the doctors also questioned administrators during an hour-long ethics discussion last week.

During that discussion, Marschall Runge, the executive vice president for medical affairs at U-M, said while a program like this has been talked about for a while at U-M, it was his decision to start it.

"I think it is of value because primarily it's a way to bring U-M supporters into our system and they will learn about health care and they will (then) donate toward health care for those not as fortunate," he said during the meeting, according to a video of the session posted on YouTube. "The program (itself) isn't likely to generate much of a margin, but the philanthropy will."

In his talk, Runge used a slide showing Michigan Medicine provided $67 million in care in 2016 to those who could not afford it. The system had 2.3 million clinic visits in fiscal year 2016 and performed 54,000 surgeries that same year. It has 26,000 employees, including 2,700 faculty members and 5,000 nurses.

He said the introductory cost is basically the amount of money a person can put into a health savings account. He said the program would be capped at 600 patients.

Concierge care is growing across the country. Places such as the Mayo Clinic in Rochester, Minn.; Stanford Health Care in Palo Alto, Calif.; Duke Health in Durham, N.C., and Boston'sMassachusetts General Hospital offer it. The number of doctors practicing concierge care is still small. About 7% of physicians practice some form of concierge medicine, but nearly 9% said they plan to switch to a concierge practice in the next couple of years, according to a 2016 survey of 17,000 doctors by the physician staffing firm Merritt Hawkins.

Daniel Berland, associate professor of internal medicine, isn't a fan of the program. He said it sets up a tiered system that sets up winners and losers in the race for tight medical care resources.

Susan Goold, professor of internal medicine and health management and policy, said she believes there are ethical questions that must be addressed.

"Does this make it harder for people who don't pay for Victors Care to see their doctor or get in to get a test they need done?" she told the Free Press. "That's an issue of fairness for a public university. It's not just because it's supported by public dollars, but our mission -- we serve the public."

Contact David Jesse: 313-222-8851 or [email protected]. Follow him on Twitter: @reporterdavidj